Its a problem of national proportions. For years state and local governments have been seeking solutions to deal with their regions ever-growing number of uninsured families and individuals. For one Florida county, a workable solution has been in place for two years. Since June of 2006, the Health Care District of Palm Beach County has operated a program so successful, its now being offered to an expanded number of residents.
Vita Health is an affordable, shared-cost program that offers health coverage rather than health insurance. Eligible residents are between the ages of 1 and 65, have been uninsured during the preceding six months and meet income criteria. Palm Beach County residents pay only one-third the cost of premiums, which range from $25 to $100 monthly. The Health Care District of Palm Beach County pays the other two-thirds of the premium.
Palm Beach County residents voted to create this special independent taxing district twenty years ago in an effort to build a healthier community. Funded by property taxes, the Health Care District of Palm Beach County provides an array of healthcare services including trauma care, Vita Health, and dedicated nurses in 170 public schools.
The Health Care Districts Chief Executive Officer, Dwight D. Chenette says proudly, “Providing solutions for the uninsured is a complex challenge and one that the Health Care District has made a priority for nearly two decades.” Chenette estimates that Palm Beach County has more than 250,000 uninsured, with more than half that number lacking coverage for a year or longer. Nearly one in five in this group has never had coverage. He cites cost as the primary reason behind lack of coverage.
Debi Gavras, Core Operations Officer for the Health Care District oversees the Managed Care programs and notes how the benefits of Vita Health enable individuals to gain access to critical preventative care services. Gavras has seen Vita Healths success story validated in concrete terms, both by utilization data and interviews with participants. She explains that Vita Health members primarily fall into three categories: those who have been uninsured for a long period of time, unemployed individuals and people who work for an employer that doesnt offer health insurance.
“Vita Health links members with a primary care physician, which establishes a medical home. Weve seen this reduce inappropriate use and overcrowding of our regions emergency rooms, which many times become a source of medical treatment for the uninsured.” Gavras observes. Vita Health members have been shown to visit an ER at a much lower rate (12/1000) than Medicaid HMO participants in Palm Beach County (38/1000). She points out that individuals with primary care physicians are often able to avoid hospital care through early identification of disease. That fact alone reduces the burden of uncompensated care which hospitals typically experience when treating uninsured individuals.
“In addition, weve observed that people who arent getting regular medical care show up with more advanced conditions by the time they do get treatment. Early intervention and consistent medical care prevent people from needing more complex and expensive treatment farther down the road,” Gavras explains. “Vita Health gives participants the chance to have timely care because they have access to a physicians office right away.” Her observation is supported by a recently-conducted Florida insurance study that showed a link between lack of coverage and either delayed or skipped medical treatment by more than half of the states uninsured.
Vita Health offers participants a network of primary and specialty physicians throughout Palm Beach County. It covers inpatient acute care, emergency room services, outpatient surgery, diagnostic services, primary care services, physician services and prescription drugs. The program also promotes wellness and offers preventive health care services. In October of this year the program was expanded through Florida State legislation, raising the income eligibility for Vita Health to 300 percent of the Federal Poverty Level (FPL). This translates into allowable incomes at $31,200 annually for individuals and $63,600 for a family of four.
Gavras is enthusiastic about Vita Healths expansion. “With an expanded income level, Vita Health will continue to grow. More residents than ever will have a medical home, and this in turn reduces our Countys rate of uncompensated care, emergency room overcrowding, and we prevent more expensive care due to delayed access to healthcare.”
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